Podcast
Questions and Answers
What is the purpose of using Heparinized Solution during surgery?
What is the purpose of using Heparinized Solution during surgery?
- To decrease clotting ability of blood (correct)
- To visualize blood vessels
- To stimulate heart contractions
- To relax blood vessels
Which medication is specifically used to relax blood vessels?
Which medication is specifically used to relax blood vessels?
- Heparinized Solution
- Contrast Dye
- Sarin
- Papavarine (correct)
For which condition is a Coronary Artery Bypass Graft (CABG) primarily indicated?
For which condition is a Coronary Artery Bypass Graft (CABG) primarily indicated?
- Three-vessel coronary artery disease (correct)
- Aneurysms of the heart
- Single vessel disease
- Valvular heart disease
What is the main benefit of using the left internal mammary artery (LIMA) as a graft?
What is the main benefit of using the left internal mammary artery (LIMA) as a graft?
What is the primary function of a pacemaker?
What is the primary function of a pacemaker?
What is a significant feature of an Implantable Cardioverter Defibrillator (ICD)?
What is a significant feature of an Implantable Cardioverter Defibrillator (ICD)?
What surgical procedure is performed to re-establish blood flow to an obstructed leg?
What surgical procedure is performed to re-establish blood flow to an obstructed leg?
Which of the following types of grafts is considered best for patency and longevity in bypass surgeries?
Which of the following types of grafts is considered best for patency and longevity in bypass surgeries?
What is the primary goal of performing a CABG procedure?
What is the primary goal of performing a CABG procedure?
What role does Contrast Dye play in surgical procedures?
What role does Contrast Dye play in surgical procedures?
What role does the perfusionist play during cardiac surgery?
What role does the perfusionist play during cardiac surgery?
Which sutures are commonly used for valve repair and replacements?
Which sutures are commonly used for valve repair and replacements?
What is the primary purpose of the Cardiopulmonary Bypass Machine during surgery?
What is the primary purpose of the Cardiopulmonary Bypass Machine during surgery?
Where is the venous cannula inserted during a surgical procedure?
Where is the venous cannula inserted during a surgical procedure?
What is the role of the cardioplegia catheter during surgery?
What is the role of the cardioplegia catheter during surgery?
During the induction phase of general anesthesia, which patient condition requires close monitoring?
During the induction phase of general anesthesia, which patient condition requires close monitoring?
What type of blood flows through the pulmonary arteries?
What type of blood flows through the pulmonary arteries?
Which layer of the heart wall is responsible for the muscular contraction of the heart?
Which layer of the heart wall is responsible for the muscular contraction of the heart?
What does the number of diseased coronary arteries indicate during surgical preparation?
What does the number of diseased coronary arteries indicate during surgical preparation?
Which valve regulates blood flow from the right atrium to the right ventricle?
Which valve regulates blood flow from the right atrium to the right ventricle?
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Study Notes
Cardiac Anatomy
- Chambers of the Heart: Right atrium, right ventricle, left atrium, left ventricle.
- Valves: Tricuspid (between right atrium and ventricle), pulmonary (between right ventricle and pulmonary arteries), mitral (between left atrium and ventricle), aortic (between left ventricle and aorta).
- Heart Walls: Epicardium (outer layer), myocardium (muscle layer), endocardium (inner layer).
Blood Circulation
- Deoxygenated Blood Pathway: Superior and inferior vena cava > right atrium > tricuspid valve > right ventricle > pulmonary valve > pulmonary arteries > lungs.
- Oxygenated Blood Pathway: Pulmonary veins > left atrium > mitral valve > left ventricle > aortic valve > aorta > body.
Nursing Interventions
- Cardiac Catheterization Report: Assess stenosis in coronary arteries for potential bypass grafts.
- Coronary Artery Disease Indicators: Number of diseased arteries suggests needed sutures and surgery duration; report may indicate left ventricular function.
- Anesthesia: General anesthesia with endotracheal tube; critical monitoring for patients with ventricular ischemia.
- Surgical Position: Supine position for median sternotomy during valve replacement/repair or coronary artery bypass grafting (CABG).
- Sutures Used in Surgery:
- Surgipro/Prolene: Synthetic, non-absorbable, monofilament for vessel anastomosis.
- Ticron: Synthetic, non-absorbable, braided for valve repairs; common sizes are #11 and #15.
Cardiopulmonary Bypass Machine (CPBM)
- Function: Temporarily replaces heart and lung function by diverting blood flow.
- Components:
- Venous Cannula: Diverts deoxygenated blood from right atrium.
- Arterial Cannula: Returns oxygenated blood into the aorta.
- Cardioplegia Catheter: Administers cardioplegia to prevent ischemic damage during surgery.
- Venous Reservoir: Collects venous blood pre-oxygenation and temperature control.
Medications and Solutions in Surgery
- Heparinized Solution: Anticoagulant to reduce clotting during surgery.
- Papaverine: Vasodilator to relax blood vessels and facilitate surgery.
- Contrast Dye: Visualizes blood vessels during imaging.
Coronary Artery Bypass Grafts (CABG)
- Indication: Patients with left main or three-vessel coronary artery disease (CAD).
- Goal: Revascularize ischemic myocardium to alleviate angina pectoris.
- Graft Choices:
- LIMA: Left internal mammary artery for left anterior descending artery.
- RIMA: Right internal mammary artery for right coronary artery.
- Advantages of Mammary Arteries: Excellent long-term patency and already connected to aorta.
Pacemaker
- Purpose: Senses and corrects bradycardia/tachycardia to restore normal heart rhythms; initiates heart contractions.
Implantable Cardioverter Defibrillator (ICD)
- Function: Monitors and delivers shocks for ventricular tachycardia or fibrillation; can pace the heart.
Femoral Popliteal Bypass
- Indication: Restores blood flow to one leg when major arterial blockage occurs.
- Graft Choice: Saphenous vein is preferred for its long-term durability.
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